CC BY-NC-ND 4.0 · Asian J Neurosurg 2024; 19(02): 327-333
DOI: 10.1055/s-0044-1787117
Case Report

Collision Tumor Composed of Nonfunctioning Pituitary Adenoma and Meningioma in the Sellar Region: Report of a Case and Literature Review

1   Department of Neurosurgery, SS Baldawa Neurosciences and Women's Care Hospital, Solapur, Maharashtra, India
Abhay Raikhailkar
2   Department of Pathology, SS Baldawa Neurosciences and Women's Care Hospital, Solapur, Maharashtra, India
› Author Affiliations
Funding None.


Background The coexistence of two histologically distinct neoplasms in the same area without histological admixture or an intermediate cell population zone represents a rare tumor type called collision tumor. Collision tumor of pituitary adenoma and meningioma has been reported years later following irradiation to pituitary adenoma. However, collision tumor of pituitary adenoma and meningioma in absence of irradiation therapy is extremely uncommon.

Case Description We report an unusual case of collision tumor involving diaphragma sella meningioma and pituitary adenoma in a 50-year-old lady without prior radiation therapy. She presented with visual blurring and impaired field of vision. Her preoperative magnetic resonance imaging (MRI) was suggestive of pituitary adenoma. Total excision of the lesion was performed through endoscopic transsphenoidal route. Histological diagnosis was consistent with collision tumor of pituitary adenoma and meningioma.

Conclusion Collision tumor comprising of nonfunctioning pituitary adenoma and meningioma is extremely rare. Preoperative MRI may not always be able to distinguish these histologically distinct neoplasms. Hence, histopathological examination is necessary to establish the diagnosis. Endoscopic transsphenoidal approach may suffice in excision of these collision tumors. Close follow-up is necessary to detect tumor recurrence. Though the association of these tumors can be coincidental, casual relationship between the occurrence of collision tumors cannot be totally excluded.

Publication History

Article published online:
27 May 2024

© 2024. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

  • References

  • 1 Zhao Y, Zhang H, Lian W. et al. Collision tumors composed of meningioma and growth hormone-secreting pituitary adenoma in the sellar region: case reports and a literature review. Medicine (Baltimore) 2017; 96 (50) e9139
  • 2 Karsy M, Sonnen J, Couldwell WT. Coincident pituitary adenoma and sellar meningioma. Acta Neurochir (Wien) 2015; 157 (02) 231-233
  • 3 Amirjamshidi A, Mortazavi SA, Shirani M, Saeedinia S, Hanif H. ‘Coexisting pituitary adenoma and suprasellar meningioma-a coincidence or causation effect: report of two cases and review of the literature’. J Surg Case Rep 2017; 2017 (05) rjx039
  • 4 Finzi G, Cerati M, Marando A. et al. Mixed pituitary adenoma/craniopharyngioma: clinical, morphological, immunohistochemical and ultrastructural study of a case, review of the literature, and pathogenetic and nosological considerations. Pituitary 2014; 17 (01) 53-59
  • 5 Gezer E, Cantürk Z, Selek A. et al. Cushing's disease due to a pituitary adenoma as a component of collision tumor: a case report and review of the literature. J Med Case Rep 2020; 14 (01) 59
  • 6 Nedeljkovic A, Ilic R, Nedeljkovic Z, Milicevic M, Raicevic S, Grujicic D. A unique case of intracranial collision tumor composed of ganglioglioma WHO gr I and supratentorial ependymoma WHO gr III: case-based literature review. Childs Nerv Syst 2023; 39 (09) 2407-2411
  • 7 Zhang Z, Yang Y, Zhang K. et al. Collision tumor of glioblastoma and meningioma: case report and literature review. World Neurosurg 2018; 117: 137-141
  • 8 de Vries F, Lobatto DJ, Zamanipoor Najafabadi AH. et al. Unexpected concomitant pituitary adenoma and suprasellar meningioma: a case report and review of the literature. Br J Neurosurg 2023; 37 (04) 677-681
  • 9 Ruiz-Juretschke F, Iza B, Scola-Pliego E, Poletti D, Salinero E. Coincidental pituitary adenoma and planum sphenoidale meningioma mimicking a single tumor. Endocrinol Nutr 2015; 62 (06) 292-294
  • 10 Prevedello DM, Thomas A, Gardner P, Snyderman CH, Carrau RL, Kassam AB. Endoscopic endonasal resection of a synchronous pituitary adenoma and a tuberculum sellae meningioma: technical case report. Neurosurgery 2007; 60 (4, suppl 2): E401
  • 11 Cannavò S, Curtò L, Fazio R. et al. Coexistence of growth hormone-secreting pituitary adenoma and intracranial meningioma: a case report and review of the literature. J Endocrinol Invest 1993; 16 (09) 703-708
  • 12 Zentner J, Gilsbach J. Pituitary adenoma and meningioma in the same patient. Report of three cases. Eur Arch Psychiatry Neurol Sci 1989; 238 (03) 144-148
  • 13 Banik S, Hasleton PS, Lyon RL. An unusual variant of multiple endocrine neoplasia syndrome: a case report. Histopathology 1984; 8 (01) 135-144
  • 14 Honegger J, Buchfelder M, Schrell U, Adams EF, Fahlbusch R. The coexistence of pituitary adenomas and meningiomas: three case reports and a review of the literature. Br J Neurosurg 1989; 3 (01) 59-69